The first cases of influenza in Maryland appeared at Camp Meade on September 17th. As the death rate from influenza rose, military officials began equating influenza deaths with those on the battlefield. A memorial service for those who died during the pandemic at Camp Meade was held and the presiding officer read the names of each dead soldier. As each name was read, the Sergeant saluted and said "Died on the field of honor, sir." By September 28th, when the state filed its first official report with the Public Health Service, state officials believed that there were 1,713 cases in the state. The real number, however, was probably much higher. By October 12th, state officials were reporting 24,300 cases. By mid-October, there were so many cases that state officials were unable to file a report. On November 16th, the number of cases had dropped to 4,929 and state officials were better able to provide reports to the Public Health Service. The PHS believed that the epidemic in Maryland had traveled along the state's transportation networks. The virulence of the disease was believed to be strongest in the areas where the disease appeared first, thus, Fort Meade was hardest hit. These assumptions were, however, just that---assumptions. The Public Health Service lacked any real evidence to support their beliefs.

Oath-taking ceremony at Camp Meade, Maryland. Camp Meade was the first part of Maryland struck by the pandemic and was also the most devastated by it. [Credit: Library of Congress]

In Cumberland, 41% of the population became ill. City officials converted buildings on the city's main street into emergency hospitals but there were only three nurses to staff these hospitals. Officials asked the Maryland Board of Health for additional nurses but the nurses never appeared. By early October, the local Red Cross chairman was lamenting that "the matter seemed far beyond control...Reports were spreading fast that 'this one' or 'that one' had died without doctor or nurse and it was a panic indeed."

In Baltimore, the city's health officer believed that there was " no special reason to fear an outbreak in our city." But by the end of September, cases of influenza had soared and the situation had become serious. Yet officials remained reluctant to take action. Insisting that "drastic measures" would cause panic and lower people's resistance to disease, city officials resisted closing schools and banning public gatherings.

1903. Johns Hopkins Hospital, Baltimore, Maryland. Johns Hopkins hospital was overwhelmed during the pandemic and lost many of its own nurses and doctors to the flu. [Credit: The Library of Congress]

By October 10th, the number of new cases in Baltimore had reached at least 1,962. By the following week, the week ending October 18th, 1,357 deaths from influenza had been reported in Baltimore. Over 150 deaths from influenza occured on October 19th alone.

Residents remained surprisingly optimistic that the pandemic would end soon. A local paper encouraged this belief by pointing out that the rising death toll indicated that the epidemic was reaching a "climax." Once the climax was reached, the paper reassured readers, influenza rates would "fall sharply."

Meanwhile, Baltimoreans across the city were infected with influenza. Milkmen, firefighters, telephone operators, and even gravediggers failed to report for work.Deaths went unrecorded as the city workers who processed death certificates were out sick. Funeral homes overflowed and bodies began to be stacked up outside these buildings.

The city's hospitals were overwhelmed. At Johns Hopkins Hospital, influenza patients occupied six full wards. Ultimately, the hospital was forced to close its doors altogether. Three staff physicians, three medical students and six nurses died in the epidemic.

Slowly and reluctantly, Baltimore city officials implemented sterner measures, closing schools and outlawing public gatherings. But by then it was too late. At least 75,000 of the city's residents had contracted influenza and more than 2,000 had died from the disease. During a more typical influenza season, fewer than five deaths would have occurred in Baltimore.

Influenza faded in November, although it lingered well into the winter and spring of 1919. By the summer, the disease had disappeared from most of the state.